Fibromyalgie und myofasziales Schmerzsyndrom gehen oft Hand in Hand. Aufgrund häufiger Überlappungen und ähnlicher Symptome werden sie häufig mit den gleichen Bedingungen verwechselt. Infolgedessen werden Menschen mit beiden manchmal nur mit einer Diagnose diagnostiziert und behandelt.
Die Unterscheidung zwischen myofaszialem Schmerzsyndrom (MPS) und Fibromyalgie (FMS) ist aus drei Hauptgründen grundlegend:
Sie erfordern eine andere Behandlung.
Sie können die Triggerpunkte beseitigen.
MPS-Schmerzen können FMS verschlimmern und die MPS-Behandlung kann FMS beruhigen.
Einige Forscher verwenden den Namen “chronischer myofaszialer Schmerz” (CMP) anstelle des myofaszialen Schmerzsyndroms, da es sich um eine Krankheit handelt und nicht um ein Syndrom. (Ein “Syndrom” ist ein Satz von Symptomen ohne bekannte Ursache.)
Was ist das Myofasziale Schmerzsyndrom?
Bei MPS entwickeln Muskeln und Bindegewebe (aus denen die Faszie besteht) einen sogenannten Trigger Point (TRP). (Diese Punkte unterscheiden sich nicht von den sensiblen Punkten des FMS.) Ein Triggerpunkt ist ein kleiner, harter Knoten, der manchmal unter der Haut spürbar ist. Der Knoten selbst kann schmerzhaft sein, insbesondere wenn er gestochen wird, verursacht aber oft Schmerzen in einem anderen Bereich, der als “Schmerz” bezeichnet wird.
Aktivierungspunkte werden typischerweise als Folge eines Gewebetraumas gebildet. Experten wissen nicht, warum der Schaden, der normalerweise bei den meisten Menschen geheilt wird, bei anderen PGs verursacht. Studien deuten jedoch darauf hin, dass Muskeltrauma bei manchen Menschen zu Fehlbildungen führt, bei denen Nervenzellen mit Muskelzellen verbunden sind. Dies legt nahe, dass MPS eine neuromuskuläre Erkrankung ist.
Warum Fibromyalgie und Myofasziales Schmerzsyndrom zusammengehören
Warum Menschen mit MPS häufig FMS entwickeln, ist noch nicht klar, aber eine wachsende Zahl von Beweisen zeigt, dass chronische Schmerzen Veränderungen im zentralen Nervensystem bewirken können, was zu einer zentralen Sensibilisierung führt. Allerdings entwickeln nicht alle Menschen mit MPS FMS. Wenn die Theorien stimmen, kann eine frühzeitige Behandlung von MPS dazu beitragen, FMS zu verhindern.
Ein allgemeiner Begriff, der sich aus FMS, MPS und anderen Erkrankungen im Zusammenhang mit der zentralen Sensibilisierung ergibt, sind zentrale Sensibilitätssyndrome.
Die Symptome des Myofaszialen Syndroms und Fibromyalgie-Schmerz
Einige der mit MPS verbundenen Symptome ähneln den mit FMS verbundenen Symptomen, andere scheinen sich zu unterscheiden. Die Symptome, die sie gemeinsam haben, sind:
Weichteilschmerzen von mild bis stark
Kopfschmerzen und / oder Migräne
Schlafstörungen
Die Probleme des Gleichgewichts und / oder Schwindelgefühls
Tinnitus (Ohrenklingeln) und Ohrenschmerzen
Speicherprobleme
Unerklärliches Schwitzen
Verschlechterung der Symptome aufgrund von Stress, Klimaänderungen und / oder körperlicher Aktivität
Die mit PMS, aber nicht mit FMS verbundenen Symptome sind:
Taubheit in den Extremitäten
Klickt oder klickt Verbindungen
Eingeschränkter Bewegungsspielraum in den Gelenken, insbesondere im Kiefer
Siehe doppelt oder verschwommen
Unerklärliche Übelkeit
Zu den Symptomen bei FM, jedoch nicht bei MPS:
Müdigkeit
Panikattacken
Er fühlt sich von den hohen sensorischen Informationen überwältigt
Allergien und Empfindlichkeiten
Zeitungsverwirrung und Desorientierung
Die Diagnose des Myofaszialen Schmerzsyndroms
Aufgrund des Schmerzes ist es besonders schwierig, MPS zu diagnostizieren und zu behandeln. Normalerweise sagt der Arzt: “Wo tut es weh?” Und dann schauen Sie, wohin Sie zeigen. Für die Behandlung von MPS müssen Sie und Ihr Arzt Ihre Symptome untersuchen und herausfinden, wo sich Ihre Triggerpunkte befinden.
Ihr Arzt kann Triggerpunkte durch Berührungen oder aufgrund von Symptomen feststellen: Tests wie die Magnetresonanz-Elastographie und die Gewebe-Biopsie können Anomalien in den TrPs zeigen, aber ihre Rolle bei der Diagnose von MPS ist noch unklar.
Im Gegenteil, es gibt keinen Test oder keine Analyse, die Auffälligkeiten in den Geweben zeigt, in denen Menschen mit Fibromyalgie Schmerzen haben.
Die Behandlung des Myofaszialen Schmerzsyndroms
Sie haben mehrere Möglichkeiten zur Behandlung von MPS:
Wendepunkt der Injektion: Der Arzt führt eine Nadel direkt in einen PRO oder an mehreren Stellen ein, um die gespannten Bänder zu lockern. Der Arzt kann ein Medikament zur Schmerzlinderung injizieren, beispielsweise Kortikosteroide oder Lidocain. (Hinweis: Einige Ärzte glauben, dass Kortikosteroide die Symptome der Fibromyalgie verschlimmern können.) Wenn keine Medikamente verwendet werden, spricht man von trockener Nadelung.
Akupunktur: Akupunktur ist eine alte chinesische Praxis, die dem Trockennadeln ähnelt: Studien zur Verwendung bei MPS sind zwar begrenzt, jedoch vielversprechend und viele Patienten und Ärzte berichten von guten Ergebnissen.
Physikalische Therapie: Eine spezielle Art der Therapie, die Sprinkeln und Dehnen genannt wird, ist für die Behandlung von MPS üblich. Ein Physiotherapeut führt Sie durch Dehnübungen während der Anwendung einer Substanz eines Anästhetikums im Muskel. Der Therapeut kann auch einige Massagetechniken anwenden, um die Muskeln und das TRPS zu entspannen, und ein Therapeut kann mit Ihnen an Faktoren wie schlechter Haltung arbeiten, die zu MPS beitragen können.
Medikamente: Zu den gängigen Medikamenten für MPS gehören nichtsteroidale entzündungshemmende Medikamente (NSAIDs), wie Aleve (Naproxen) oder Ibuprofen-basierte Medikamente wie Advil und Motrin und tricyclische Antidepressiva wie Amitriptylin, Doxepin und Nortriptylin.
MPS-Behandlungen Behandlungen gegen FMS
Es gibt wieder eine gewisse Überschneidung, aber auch wichtige Unterschiede. Die Behandlungen für MPS und FMS sind:
Akupunktur
Körperliche Therapie (auf verschiedene Weise)
Trizyklische Antidepressiva (obwohl SSRI / SNRI-Antidepressiva zunehmend für FMS üblich sind)
Studien zeigen, dass Triggerpunkt-Injektionen nicht wirksam sind, um empfindliche Punkte der Fibromyalgie zu lindern, und NSAIDs sind bei der Behandlung von FMS-Schmerzen nicht wirksam, da die anvisierte Entzündung und das FMS nicht als entzündlicher Zustand bekannt sind.
Leben mit Fibromyalgie und myofaszialem Schmerzsyndrom
Bei signifikanten Unterschieden in Symptomen, Diagnose und Behandlung ist es offensichtlich, dass Fibromyalgie und myofasziales Schmerzsyndrom nicht derselbe Zustand sind. Als jemand, der beides hat, weiß ich jedoch, dass es extrem schwierig sein kann, zu bestimmen, welcher Zustand den Schmerz verursacht.
Wenn Sie sowohl alleine als auch mit Ihrem Arzt und / oder Physiotherapeuten zusammenarbeiten, können Sie möglicherweise herausfinden, wo Sie Triggerpunkte haben und wie Sie diese am besten behandeln können, ohne die Fibromyalgie zu verschlimmern. Durch die Linderung myofaszialer Schmerzen werden wahrscheinlich die Symptome der Fibromyalgie gelindert, so dass Sie einen doppelten Nutzen sehen können.
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